JOURNEY PEDIATRICS PC; NPI #1205205630

Contact Information

JOURNEY PEDIATRICS PC

8308 CONSTITUTION PL NE
ALBUQUERQUE, NM 87110

Phone: 505-883-9570
Fax: 505-883-4163
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Primary Care	261QP2300X

Indicates primary specialty

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NPI Profile & details for JOURNEY PEDIATRICS PC

NPI Number 1205205630

LBN Legal business name JOURNEY PEDIATRICS PC

Authorized official ALWYN KOIL - (OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 09/16/2015

Last updated 09/25/2025 - About 8 months ago

Identifiers

NM	License #	2003-0567
NM	Medicaid	85684392

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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